As I understand it, it will be a UK vote broken down by country and
possibly by type of GP eg sessional / principals / trainees. There is no
further localisation.
If A is implemented there will be a DES. If 50% or more of local
practices take it up there will be no need for the PCT to go further.
Some people think their PCTs will turn a blind eye to the DES rules in
order to hit the targets. If less than 50% take it up the PCT will have
to do one of two things:
* Set up a parallel DES sitting alongside the DES, with better terms
(eg such as allowing practices to share the opening hours) which
will encourage more practices to take part
* Alternatively they may take the view that this is a DES, they have
to deliver it and if practices won't take it up they will offer it
to alternative providers. The main disadvantage of this is that
the alternative providers will have difficulty achieving the "50%
of practices open" target for them.
I think the "PCTs will take the money and use it to open Darzi centres"
scenario is fanciful because that won't help them hit the target. Anyway
they have other money to open Darzi centres.
Fay
Paul Caldwell wrote:
> fay, have we the option of saying B at a local level? could we get
> together with the other surgery in my town and offer the PCT a DES or
> LES extended hours surgery?
>
> > Date: Sat, 9 Feb 2008 09:19:03 +0000
> > From: [log in to unmask]
> > Subject: Re: What's going on?-me depressed thats what.
> > To: [log in to unmask]
> >
> > Sorry Roger it may be fatigue but I'm not sure I understand the
> question.
> > There is quite a lot of detail about the DES available from the
> Britnell
> > letter and Alan Johnson's letter to MPs. If there are any changes to
> the
> > details I'd expect them to be published before the poll.
> >
> > Some PCTs are in the process of developing LESs already but that is a
> > local activity not national so whether you have those details locally
> > before the vote depends on where you are.
> >
> > Is this what you meant?
> > Fay
> >
> > Roger Gardiner wrote:
> > > Fay
> > >
> > > Are full details of pricing, proportion of OOH to be face-to-face as
> > > opposed to admin, monitoring, approval needed etc. for each option
> > > available or are we going to be voting on 'work in progress'?
> > >
> > > Roger
> > >
> > >
> > > -----Original Message-----
> > > From: Fay Wilson <[log in to unmask]>
> > > To: [log in to unmask]
> > > Sent: Sat, 9 Feb 2008 1:14
> > > Subject: Re: What's going on?-me depressed thats what.
> > >
> > > To put you out of your misery
> > >
> > > If Option A is accepted it will be a DES.
> > > This means it is optional and your practice doesn't have to do it.
> > >
> > > The PCT then has two choices:
> > > It may (if >50% of GPs opt out) set up a parallel LES with better
> > > terms - because the target is compulsory for PCTs
> > > or
> > > As it is a DES it will be entitled to commission the service from
> > > another provider. Step in (Insert name of APMS provider here)
> > >
> > > If Option B is accepted (or rather imposed if we don't accept A ) as
> > > far as I can see from the Britnell letter the PCT has to make
> > > arrangements with its local practices (ie a LES) and there is no
> > > provision for going elsewhere, so it will have to be more flexible
> and
> > > attractive than the DES.
> > >
> > > Fay
> > > DOI: Medical Director of an APMS OOH provider. Still voting B
> > >
> > >
> > >
> > > Paul Caldwell wrote:
> > > > thoroughly depressed now. i have to say, i just cannot face working
> > > > extended hours on top of normal duties. i simply do not have the >
> > > mental energy left to do it, and i think this is too much for my >
> > > health. Unless there is some flexibility in the extended hours >
> > > (lunchtime start, no extres, no visits) then my draft resignation
> (see
> > > > posting passim) is going in. I'll be financially worse off but at >
> > > least less chance of recurrence of recent depressive illness which
> was
> > > > part work-stress related, and i'll see my family. Helen is decidely
> > > > dew-eyed at the moment but thinks it would be best "we cannot
> have u
> > > > depressed again, it was hell that time". Except i dont think
> there >
> > > will be any flexibility allowed, afterall this is /really /about >
> > > seeing more pts faster and nothing to do with quality health care. >
> > > even some shift work will cause havoc in our surgery. this am, if the
> > > > late surgery doctor came in at lunchtime, with annual leave and >
> > > sickness (more of that will occur in future too), it would have
> left >
> > > x2 doctors this am for 15K pts-unacceptable and unsafe, which is >
> > > partly why the DOH wont allow flexibility.
> > > >
> > > > > Date: Fri, 8 Feb 2008 18:06:01 +0000
> > > > > From: [log in to unmask] <mailto:[log in to unmask]>
> > > > > Subject: Re: What's going on?
> > > > > To: [log in to unmask] <mailto:[log in to unmask]>
> > > > >
> > > > > On 08/02/2008, Geoff Schrecker <[log in to unmask]
> > > <mailto:[log in to unmask]>> wrote:
> > > > > > When at last the profession was largely united behind taking a
> > > stand.
> > > > > > :-(
> > > > >
> > > > > I'm a bit puzzled. I thought they weren't allowed to advise
> GPs what
> > > > > to do about the dispute?
> > > > >
> > > > > Or are they allowed to tell us to obey the Government but not
> allowed
> > > > > to tell us to resist?
> > > > >
> > > > > Odd, as you say.
> > > > >
> > > > > --
> > > > > Michael Leuty
> > > > > Nottingham, UK
> > > >
> > > >
> > >
> ------------------------------------------------------------------------
> > > > She said what? About who? Shameful celebrity quotes on Search Star!
> > > > <http://www.msnsearchstar.com>
> > > >
> > >
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